Stay with them, stay calm, and help them ride it out. A panic attack typically peaks within 10 minutes and resolves within 5 to 20 minutes, so your main job is to be a steady, reassuring presence during that window. Most panic attacks are not dangerous, but they feel terrifying to the person experiencing one. Knowing what to do (and what not to do) can make a real difference in how quickly they recover.
Recognize What’s Happening
A panic attack floods the body with fight-or-flight chemicals even when there’s no actual threat. The brain’s fear center triggers a cascade that spikes blood sugar and heart rate, preparing the body to run from danger that doesn’t exist. The result is a set of physical symptoms that can look alarming from the outside: a pounding or racing heart, trembling, sweating, difficulty breathing, chest pain, dizziness, numb or tingling hands, nausea, and chills.
Because these symptoms hit suddenly and intensely, the person may genuinely believe they’re dying or having a heart attack. That belief fuels more panic, which fuels more symptoms. Understanding this cycle helps you respond with calm confidence instead of matching their alarm.
What to Do in the Moment
The most important thing is to not panic when they panic. Your calm is contagious. If you tense up, rush around, or look frightened, it reinforces the sense that something is truly wrong. Take a breath yourself before you step in.
From there, follow these steps:
- Stay with them. Don’t leave to get help unless there’s a medical emergency. Your physical presence is grounding.
- Move them somewhere quiet if possible. Fewer stimuli means less to process.
- Speak in short, simple sentences. During peak panic, the brain struggles to absorb complex information. Say things like “I’m right here” or “You’re safe.”
- Ask what they need. Some people want a hand on their shoulder. Others can’t stand being touched. Let them tell you.
- Be predictable. Avoid sudden movements or surprises. Tell them what you’re going to do before you do it.
Help Slow Their Breathing
Hyperventilation drives many of the worst panic symptoms, including dizziness, tingling, and the feeling of not getting enough air. If you can help the person slow their breathing, the physical symptoms often ease noticeably.
Box breathing is one of the simplest techniques to guide someone through. Walk them through four steps: breathe in slowly through the nose for a count of four, hold for a count of four, exhale through the mouth for a count of four, then hold again for a count of four. Repeat the cycle. Do it with them so they can match your rhythm. Counting out loud gives them something concrete to focus on besides the panic.
If box breathing feels too structured in the moment, just count slowly to ten together on each exhale. The goal isn’t perfection. It’s shifting their attention to something rhythmic and controlled.
Try a Grounding Technique
Grounding pulls a person’s attention out of their spiraling thoughts and back into their physical surroundings. The most well-known method is the 5-4-3-2-1 technique, and you can walk someone through it conversationally.
Ask them to name five things they can see, then four things they can physically touch (the fabric of their shirt, the ground under their feet), then three things they can hear, then two things they can smell, then one thing they can taste. It doesn’t matter what the answers are. The act of scanning the environment for sensory details pulls the brain out of panic mode and into the present moment. Go slowly, and give them time to answer each one.
Another simple option: ask them to do a repetitive physical task, like raising their arms over their head several times or pressing their palms together hard. Engaging large muscle groups can help discharge some of the adrenaline that’s coursing through their body.
What to Say and What Not to Say
Your words matter more than you might think. Phrases that acknowledge what they’re going through without minimizing it work best: “You can get through this,” “I’m right here with you,” “Tell me what you need right now,” and “Concentrate on your breathing.” If the person has had panic attacks before, reminding them that this will pass, just like the others did, can be especially reassuring.
What you should avoid is anything that dismisses their experience. “Just relax,” “stop worrying,” “it’s all in your head,” “you’re being silly,” and “just get over it” all make things worse. These phrases communicate that the person should be able to control what’s happening, which adds shame to an already overwhelming experience. Even if you don’t fully understand what they’re feeling, saying “I don’t know exactly what this feels like, but I’m here for you” is far more helpful than trying to fix it with logic.
How to Tell if It’s Something More Serious
Panic attack symptoms overlap significantly with heart attack symptoms, and even emergency physicians acknowledge that telling them apart can be difficult. A few differences can help you gauge the situation. Panic attacks tend to hit peak intensity within about 10 minutes and then taper off. Heart attacks more commonly start with mild discomfort that gradually worsens over several minutes and may come and go before the main event. Heart attack pain also tends to radiate to the jaw, back, or arm, particularly in women.
If the person has never experienced a panic attack before, treat the situation more cautiously. A blood clot in the lungs, for instance, can mimic panic symptoms: sudden anxiety, shortness of breath, and a sense of impending doom. If the chest pain persists beyond 20 minutes, if they faint, or if they have a history of heart disease, call emergency services. It’s always better to be evaluated unnecessarily than to dismiss something serious.
Thoughts of self-harm during or after a panic attack also warrant immediate emergency care.
After the Attack Passes
Once the peak subsides, the person will likely feel exhausted, shaky, and emotionally drained. Some people describe a “panic hangover” that can linger for hours. This is normal. The body just burned through a massive surge of stress hormones, and recovery takes time.
Help them find a comfortable, quiet spot to rest. Offer water. Gentle movement like a short walk can help relieve residual tension. Avoid offering alcohol or caffeine, both of which can ramp anxiety back up or interfere with sleep later. Don’t press them to talk about what happened right away. Some people want to process it immediately, others need space. Follow their lead.
If panic attacks are happening repeatedly, that pattern points toward panic disorder, which affects roughly 2 to 3 percent of adults in any given year. Effective treatments exist, and most people improve significantly with the right support. The most helpful thing you can do as a friend, partner, or family member is to normalize getting help without pressuring them into it.